Got a Gut Feeling You Have IBS?

Can you stomach an honest discussion on a delicate matter? Good. Here it goes: Irritable Bowel Syndrome (IBS) is a common disorder of bowel function, particularly where women are concerned.

According to the American College of Gastroenterology, twice as many women suffer from this sometimes-mysterious illness than men. (As if we didn’t already have an impressive list of female-only maladies!) This is a lot of women considering the estimates indicate about 15 to 20 percent of the U.S. population has IBS.

The reason for a higher incidence of IBS among women is not yet understood in scientific circles. But researchers have some theories.

“It is hypothesized women may be wired differently than men, receiving more or being more receptive to certain kinds of transmitter signals,” said Dr. Amy Foxx-Orenstein, an associate professor at the Mayo Clinic College of Medicine and president-elect of the American College of Gastroenterology.

Surprisingly, hormonal differences have not been proven to affect IBS, she said, noting also that menstruation does not appear to worsen the symptoms, either.

IBS is characterized by abdominal discomfort along with changes in bowel habits. Constipation or its antithesis, diarrhea, can be present — sometimes even alternating — along with bloating, loss of appetite and/or a general feeling of malaise. But here’s the kicker: Only about a quarter of those with IBS actually seek medical treatment.

Why are sufferers so reluctant to seek help for their problem?

“It is hard to say why individuals with symptoms don’t seek advice as we don’t get to talk with them, only learn about them through surveys!” said Dr. Foxx-Orenstein. “IBS is a durable condition, meaning that it can be present for years (30 or more). Many individuals who have long-standing symptoms may consider this their normal, not recalling a less aggravating time. Others may not be comfortable discussing bowel issues with any but their closest confidants.”

Also, a good many sufferers experience mild to moderate symptoms, which they find manageable. But tolerance and modesty tend to disappear, according to Dr. Foxx-Orenstein, when recurrent symptoms become severe, a situation that usually prods the reluctant sufferer to present to her family doctor right away.

There is another reason some people may be hesitant to consult a physician about IBS: it’s been a long-held belief that the condition is psychosomatic. New studies, however, indicate a different direction of scientific thought.

“Stress and anxiety do not cause IBS,” Dr. Foxx-Orenstein said. “Instead, research suggests that IBS is caused by changes in the nerves and muscles that control sensation and motility of the bowel. Over the last 20 years, a number of scientific studies have demonstrated that people with IBS tend to have higher levels of sensitivity in the intestines compared to individuals who do not have IBS.”

The disease, however, has been linked to a neuro-chemical imbalance, she said. Researchers believe serotonin, the oft-written-about neurotransmitter of antidepressant fame, has been found lurking far from the brain — in the gut.
“It [serotonin] is believed to play a key role in gastrointestinal sensation and motility and may be integral in the development of the symptoms of IBS,” Dr. Foxx-Orenstein said.

Since antidepressants affect serotonin levels, could they have any effect on sufferers of IBS? Yes, according to Dr. Foxx-Orenstein, who noted that the use of some antidepressants appears to decrease the abdominal discomfort of IBS and improve overall symptoms. Some researchers conjecture that these positive results can also be related to an improvement in the patient’s emotional state, a natural result of antidepressant use. But, whatever the reason, the fact that antidepressants seem to make IBS less severe makes them an important component in future IBS research.

Do You Suffer from IBS?

Take the IBS Quiz (courtesy of the American College of Gastroenterology)

Do you have recurrent abdominal pain or discomfort?
Do you often feel bloated?
Are you frequently constipated?
Do you have frequent diarrhea?
Have you talked to your doctor?

If you have one or all of these symptoms, you may have IBS. You should talk to your doctor or a gastrointestinal specialist to evaluate your symptoms.

For more information on IBS, visit the American College of Gastroenterology Web site.

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